PRENATAL CHARTING BASE LINES: CARE GIVERS

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PRENATAL CHARTING BASELINES
Questions For Care Givers: Policies, Partners, Support.
By L'dia Men-Na'a

  • [] Midwife [] Doula [] Educator [] Doctor
  • []  1.  What is the fee for your services? 
  • []  2.  Are your fee’s itemized according to the services provided?
  • []  3.  Prenatal care: .........$___.__
  • []       Labor and delivery: .$___.__
  • []       Postpartum care: ....$___.__
  • []  4.  What services does your fee cover?
  • []  5.  Do you take insurance, if yes which types? 
  • []  6.  Do you offer a payment plan for your services? 
  • BIRTHING PARTNERS:
  • []   7. Do you practice in a group?
  • []   8. How many partners do you have that assist you? if yes, will I have a choice of practitioners?
  • []   9. Do you plan to be away at any time during my prenatal care? 
  • [] 10. Do you do home births?
  • [] 11. Do you do births at a birthing center? 
  • [] 12. Do you do births at a hospital?
  • BIRTHING POLICIES:
  • [] 13. Do you attend to the mother throughout labor? 
  • [] 14. How long do you attend to mother following labor and delivery?
  • [] 15. Do you view birth as a natural physiological process?
  • [] 16. What is your policy on routine intervention?
  • [] 17. What is your policy on transportation to the hospital?
  • [] 18. What role do you play in a hospital environment?
  • [] 19. Do you practice natural childbirth using wholistic methods of care? 
  • [] 20. How many of your mothers have delivered without medication? 
  • [] 21. Do you require a prep before birth, such as shave or an enema?
  • [] 22. What is your policy on fetal monitoring? 
  • [] 23. Do you use a fetascope, doptone (Doppler)?
  • [] 24. Do you use continuous external monitor?
  • [] 25. Do you use a continuous internal monitor? 
  • [] 26. Do you routinely use an IV (intravenous device)?
  • [] 27. Do you allow mother to deliver in her own clothes? 
  • [] 28. Is the mother confined to the labor/delivery room or is encouraged to walk around?
  • [] 29. Is mother allowed to move and change positions in labor?

 

 

 

 

 

CHARTING BASELINES: CLICK ON IMAGE 3x TO ENLARGE

BIRTHING SUPPORT:
  • [] 30. Do you explain to mother what is going on during pregnancy and in labor?
  •          allowing her some choices and in volvement in making decisions? 
  • [] 31. Do you remain with mother continuously during labor, or do you have a nurse, apprentice, or doula stay with her?
  • [] 32. How many can be present during a routine labor/delivery?
  • [] 33. Who can be present during a cesarean delivery?
  • [] 34. Do you allow apprentices, assistants, trainees, visitors to assist or watch during labor and delivery?
  • [] 35. Do you allow apprentices, assistants, trainees, visitors who are not approved by the mother to assist?
  • EDUCATIONAL SERVICES:
  • [] 36. Do you or does someone you recommend teach childbirth education classes? 
  • [] 37. What do you recommend that a childbirth education class cover? 
  • ROUTINE TESTS AND PROCEDURES:
  • [] 38. Under what conditions do you recommend amniocentesis? 
  • [] 39. Under what conditions do you recommend ultrasound? 
  • [] 40. STI: []   HIV: [] 
  • Rating scale: Low1 2 3 4 5 6 7 8 9 10 High

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